Provider Demographics
NPI:1518975101
Name:STEWART, DEL (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEL
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 W MAIN ST
Mailing Address - Street 2:STE 103
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-7712
Mailing Address - Country:US
Mailing Address - Phone:714-878-1302
Mailing Address - Fax:
Practice Address - Street 1:232 W MAIN ST
Practice Address - Street 2:STE 103
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-7712
Practice Address - Country:US
Practice Address - Phone:714-878-1302
Practice Address - Fax:714-832-9903
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS124071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFY971Medicare UPIN